C HAPTER 32: D IABETES D RUGS
Lilley: Pharmacology and t he Nursing Process, 10th Edition
MULTIPLE CHOICE
1. A patient in the emergency department was showing signs of
hypogl ycemia and had a finger stick glucose level of 38 mg/dL. The
patient has just become unconscious. The nurse will anticipate which
action to be next?
a. Having the patient eat glucose tablets
b. Having the patient consume fruit juice, a non -diet soft drink, or
crackers
c. Administering int ravenous glucose (50% dextrose)
d. Calling the lab to order a fasting blood glucose level
ANS: C
Intravenous glucose raises blood glucose levels when the patient is
unconscious and unable to take oral forms of glucose. Having the lab
draw a fasting glucose l evel is not an appropriate action at this time.
DIF: Cognitive Level: Anal yzing (Anal ysis)
TOP: Nursing Process: Implementation
MSC: NC LEX: Safe and Effective Care Environment:
Management of Care
2. The nurse is preparing to administer insulin intravenousl y. Which
statement about the administration of intravenous insulin is true?
a. Insulin is never given intravenousl y.
b. Onl y regular insulin can be administered intravenousl y.
, c. Insulin as part or insulin lispro can be administered intravenousl y,
but there must be a 50% dose reduction.
d. Any form of insulin can be administered intravenousl y at the same
dose as that is ordered for subcutaneous administration.
ANS: B
Regular insulin is the usual insulin product to be dosed via intravenous
bolus, intravenous infusion, or even intramuscularl y. These routes,
especiall y the intravenous infusion route, are often used in cases of
diabetic ketoacidosis, or coma associated with uncontrolled t ype 1
diabetes.
DIF: Cognitive Level: Appl ying (Application)
TOP: Nursing Process: Imple mentation
MSC: NC LEX: Safe and Effective Care Environment: Safet y and
Infection Control
3. A patient with a history of chronic obstructive pulmonary disease (COPD)
and t ype 2 diabetes has been treated for pneumonia for the past week. The
patient has been rec eiving intravenous corticosteroids as well as
antibiotics as part of his therapy. At this time, the pneumonia has
resolved, but when monitoring the blood glucose levels, the nurse notices
that the level is still elevated. What is the best explanation for t his
elevation?
a. The antibiotics may cause an increase in glucose levels.
b. The corticosteroids may cause an increase in glucose levels.
c. The patient ’s t ype 2 diabetes has converted to t ype 1.
d. The hypoxia caused by the COPD causes an increased need for
insulin.
ANS: B
, Corticosteroids can antagonize the hypoglycemic effects of insulin,
resulting in elevated blood glucose levels. The other options are
incorrect.
DIF: Cognitive Level: Anal yzing (Anal ysis)
TOP: Nursing Process: Evaluation
MSC: NC LEX: Physiological Integrit y: Pharmacological and
Parenteral Therapies
4. The nurse knows to administer acarbose, an alpha -glucosidase inhibitor, at
which time?
a. 30 minutes before breakfast
b. With the first bite of each main meal
c. 30 minutes after breakfast
d. Once dail y at bedtime
ANS: B
When an alpha -glucosidase inhibitor is taken with the first bite of a
meal, excessive postprandial blood glucose elevation (a glucose spike)
can be reduced or prevented.
DIF: Cognitive Level: Appl ying (Application)
TOP: Nursing Process: Implementati on
MSC: NC LEX: Physiological Integrit y: Pharmacological and
Parenteral Therapies
5. A patient has been diagnosed with metabolic syndrome and is started on
the biguanide metformin. The nurse knows that the purpose of the
metformin, in this situation, is which of these?
a. To increase the pancreatic secretion of insulin
b. To decrease insulin resistance
Lilley: Pharmacology and t he Nursing Process, 10th Edition
MULTIPLE CHOICE
1. A patient in the emergency department was showing signs of
hypogl ycemia and had a finger stick glucose level of 38 mg/dL. The
patient has just become unconscious. The nurse will anticipate which
action to be next?
a. Having the patient eat glucose tablets
b. Having the patient consume fruit juice, a non -diet soft drink, or
crackers
c. Administering int ravenous glucose (50% dextrose)
d. Calling the lab to order a fasting blood glucose level
ANS: C
Intravenous glucose raises blood glucose levels when the patient is
unconscious and unable to take oral forms of glucose. Having the lab
draw a fasting glucose l evel is not an appropriate action at this time.
DIF: Cognitive Level: Anal yzing (Anal ysis)
TOP: Nursing Process: Implementation
MSC: NC LEX: Safe and Effective Care Environment:
Management of Care
2. The nurse is preparing to administer insulin intravenousl y. Which
statement about the administration of intravenous insulin is true?
a. Insulin is never given intravenousl y.
b. Onl y regular insulin can be administered intravenousl y.
, c. Insulin as part or insulin lispro can be administered intravenousl y,
but there must be a 50% dose reduction.
d. Any form of insulin can be administered intravenousl y at the same
dose as that is ordered for subcutaneous administration.
ANS: B
Regular insulin is the usual insulin product to be dosed via intravenous
bolus, intravenous infusion, or even intramuscularl y. These routes,
especiall y the intravenous infusion route, are often used in cases of
diabetic ketoacidosis, or coma associated with uncontrolled t ype 1
diabetes.
DIF: Cognitive Level: Appl ying (Application)
TOP: Nursing Process: Imple mentation
MSC: NC LEX: Safe and Effective Care Environment: Safet y and
Infection Control
3. A patient with a history of chronic obstructive pulmonary disease (COPD)
and t ype 2 diabetes has been treated for pneumonia for the past week. The
patient has been rec eiving intravenous corticosteroids as well as
antibiotics as part of his therapy. At this time, the pneumonia has
resolved, but when monitoring the blood glucose levels, the nurse notices
that the level is still elevated. What is the best explanation for t his
elevation?
a. The antibiotics may cause an increase in glucose levels.
b. The corticosteroids may cause an increase in glucose levels.
c. The patient ’s t ype 2 diabetes has converted to t ype 1.
d. The hypoxia caused by the COPD causes an increased need for
insulin.
ANS: B
, Corticosteroids can antagonize the hypoglycemic effects of insulin,
resulting in elevated blood glucose levels. The other options are
incorrect.
DIF: Cognitive Level: Anal yzing (Anal ysis)
TOP: Nursing Process: Evaluation
MSC: NC LEX: Physiological Integrit y: Pharmacological and
Parenteral Therapies
4. The nurse knows to administer acarbose, an alpha -glucosidase inhibitor, at
which time?
a. 30 minutes before breakfast
b. With the first bite of each main meal
c. 30 minutes after breakfast
d. Once dail y at bedtime
ANS: B
When an alpha -glucosidase inhibitor is taken with the first bite of a
meal, excessive postprandial blood glucose elevation (a glucose spike)
can be reduced or prevented.
DIF: Cognitive Level: Appl ying (Application)
TOP: Nursing Process: Implementati on
MSC: NC LEX: Physiological Integrit y: Pharmacological and
Parenteral Therapies
5. A patient has been diagnosed with metabolic syndrome and is started on
the biguanide metformin. The nurse knows that the purpose of the
metformin, in this situation, is which of these?
a. To increase the pancreatic secretion of insulin
b. To decrease insulin resistance
